MHCP enrolled pharmacies using a unit dose system approved by the Minnesota Board of Pharmacy, and who are enrolled as a unit dose dispenser, may receive an additional dispensing fee when providing legend drugs dispensed in unit dose packaging for recipients in a Long Term Care (LTC) facility.
All pharmacies dispensing prescriptions in unit dose packaging to LTC facilities must accept returns on unit dose products and refund DHS/MHCP the amount paid per unit returned. This may be done either by reversing the claim and billing for the used amount or sending a check to the Surveillance and Integrity Review Section (SIRS) at:
Surveillance and Integrity Review Section
P.O. Box 64982
St Paul MN 55164-0982
To enroll as a unit dose dispenser, complete the Provider Agreement Addendum (DHS-5329), attach an approval letter from the Minnesota Board of Pharmacy and fax or mail to:
MHCP Provider Enrollment
P.O. Box 64987
St. Paul, MN 55164-0987
651-431-2700 or 1-800-366-5411
• Unit dose packaging procedures and fees apply only to legend drugs.
• Do not bill for dispensing fees for legend drugs dispensed in unit dose packaging more often than once per calendar month or when a minimum of 30 dosage units is dispensed, whichever results in the lesser number of dispensing fees regardless of the type of unit dose system used by the pharmacy or the number of times during the month that the pharmacist dispenses the drug.
• Keep a written record of each dispensing act showing the date, National Drug Code (NDC) and quantity of drug dispensed. If the recipient's drug supply is dispensed in small increments during the calendar month, Bill only one dispensing fee.
• Bill only one dispensing fee per calendar month for each maintenance legend drug, regardless of the type of unit dose system used by the pharmacy or the number of times during the month the pharmacist dispenses the drug.
• Report the date of dispensing as the date of service on the claim to DHS, except when the recipient's drug supply is dispensed in small increments during the month. For this exception, report the last dispensing date of the calendar month on the claim to DHS as the date of service. In the case of an exception, report the quantity of drug dispensed as the cumulative total dispensed during the month or a minimum amount as required in the item above, whichever results in the lesser number of dispensing fees.
• DHS will pay an additional $0.30 (30 cents) per dispensing fee per prescription for residents of an LTC if
• The drug is dispensed using an in-pharmacy packaged unit dose system (approved by the Board of Pharmacy)
• A minimum 30-day supply of the drug is dispensed, it is allowable to dispense a lesser supply for an acute course of medication therapy for a specified time period
• The NDC from the stock container is identified on the claim to DHS
• The unit dose package containing the drug meets the packaging standards in Minnesota Statutes 151 that govern the return of unused drugs to the pharmacy for reuse, and meets permeability standards of the State Board of Pharmacy
• The pharmacy provider repays DHS the amount reimbursed for the drug cost prorated to the quantity of unused drugs eligible for return and reuse
• The provider indicates on the pharmacy claim that unit dose packaging was utilized by placing "06" in the DAW/UD code box
Drugs dispensed in unit dose packaging must be returned to a pharmacy as specified below when the recipient no longer uses the drug. This applies even if the pharmacy does not receive the unit dose dispensing fee.
• A provider of pharmacy services using a unit dose system must comply with Minnesota Rules 6800.2700.
• An LTC facility must return unused drugs dispensed in unit dose packaging to the provider that dispensed the drugs.
• The provider receiving the returned drugs must repay DHS the amount reimbursed for drug cost from which the prescription was billed, prorated to the quantity of the drug returned. The pharmacy must maintain a log containing:
• The prescription number
• Date of return
• Number of remaining units
• Actual acquisition cost per unit
• Total cost of the remaining units
The pharmacy must send a check for the amount specified above for drugs returned no more than once a month but not less than once every three months. The refunded amount should not include dispensing fees. Make checks payable to "Department of Human Services."
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